HomeMy WebLinkAboutHYDRANT PERMIT - 19-00556 - Larry Voss Constuction, FHM #835 North i st East
Rexburg, ID 83440
Date Iss
Business na
Picked up by
Address:
FIRE HYDRANT USE PERMIT •°x
NONTRADITIONAL WATER CUSTOMERS $y
Noah.phefheanQrexburg.org Phone: 208.372-2136
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www.rexburg.org Fax: 877.397.3917
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Meter # FA77_ WR Hose(rfesy No
Phone # 2G g 7E 9
Phone #
e;5�_3�fdi Year Issued: +ref
Deposit amt: (Receipt Code= WIDEN
$1,600 Large Capacity Water Meter Deposit retained? or refunded? ( date) )
$ 600 Small Capacity Water Meter
CONDITIONS OF PERMIT: persons or entity
In order to prevent possible contamination from backflow of the Rexburg city water system, any p
desiring to obtain water from a city fire hydrant must comply with the following: to take any water.
1. Obtain a written permit from Rexburg City Hall, 35 N 1 East, before attempting
2. Take water only from the one fire hydrant designated by the city water department. hydrant
3. Check out the backflow and metering device from the city water dept. to be attached to the fire by
agreed upon by the user and the city water deptment. damage to or loss of the device
4. As indicated above a deposit will be required on any metering device. Any g the balance of the
will be paid for by the user. After any use, repair, or replacement charges are deducted ,
deposit will be refunded to the user. (City water dept. will conduct a final inspection.)
5. The fee for any water obtained through the metering device is as follows:
Fee: 1-1,000 gallons $10.00 Each 1,000 gallons thereafter : $5.00
6. A $50.00 maintenance fee for 1" and $75.00 maintenance fee for 2" will be assessed each year for
maintenance on the meter.
7. The meter needs to be returned by 12/1 for testing calibrations. A meter can be reissued the same day per
request if needed.
Any person or entity not complying with this olicy shall be assessed a penalty charge of $400 in addition
to the normal charge for the water taken
REFUND TO:
METER OK:
YES OUT READ
NO IN READ
GAL. USED 3 i
READ DATE
METER RE -ISSUED? YES/6
of
CHARGES:
METER MAINT
0-1000 GAL
ADDITIONAL WATER
REPAIRS -PARTS
Issued by: Received by
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